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FAI15-0001 Fire Annual Inspection Archive (2)
d Butte County Fire Department - California Department of Forestry and Fire Protection Fire Prevention Bureau � 176 Nelson Avenue, Oroville, CA 95965 530-538-7888/530-538-2105(fax) Fire Safety Inspection Osiness Address: ;t I 3S `j L 0,m Z� Business Name: ,A EJ ,5 C q JT��,... �ner-/Manager: her Contact: Bus: �' p _ � Bus: Oth r: Other: ilding Owner: Bus: Other: dress: 11. Occ. Class: � s■_\1IILIFy, *011111Is] kiIMW191IIMEAN 14 1 WdII4:4Ilk 1:1 =170] 4 901'1'l 10 DETAILED EXPLANATION AND CORRECTIONS: CORRECTED: 6, W i W(7 H k LL -- TC.e t r --c a i 10 e CZ H A S' A RZA ZND PSC P W (v 6N Tvi c - NO ,U -t ShuwW, 5s-val-- GN S sy%v T' 0� 0+*J %Ae M,� V-OCWV \ No MYt SHOP ate: Discussed with: Si ned: t --��-j (Print) L.s�t,00 Ins ecting ricer: 0 attalion 1 2 3 4 5 6 7 Station: l FPB AtJA By order of the Fire Chief: You are hereby notified to correct all violations immediately or shcfw cause why you should not be required to do so. A re -inspection will be conducted on R - L3 Willful failure to comply with this notice is a r%isdemeanor. Violations that are not corrected immediately and/or remain after the re -inspection may be processed as a criminal offense. Thank you for your assistance and cooperation in minimizing the fire and life loss in our community. (H & S sec. 13112) White Copy — Station File Yellow Copy — Re-inspect/business Pink Copy — Business 0 Check when sent to prevention 1. Fire extinguishers: required, service due 0 10. Exit(s): obstructed, inadequate 2. Extension cords: Excessive use, defective 11. Exit sign(s): required, illumination, photo luminescent 3. Excessive rubbish, trash, debris V 4 12. Exit sign lights: obstructed, defective t 4. Fire alarms stem defective t - 13. Exit lighting: required, defective V- 5. Sprinkler system: service required, defective i �- 14. Heatingsystem: defective appliance, flue combustibles fl 6. Kitchen hood ext. system: service due 15. Wiring: exposed, damaged connectors, etc. \L 7. Fire walls, ceilings, fire doors, draft stops oa- 16. Address posted and visible from road 8. Smoke detectors: required, defective a Y-- 17. Other 9. Fire drill logchecked Yes 0 No 0 0 18. Other type of inspection - State below DETAILED EXPLANATION AND CORRECTIONS: CORRECTED: 6, W i W(7 H k LL -- TC.e t r --c a i 10 e CZ H A S' A RZA ZND PSC P W (v 6N Tvi c - NO ,U -t ShuwW, 5s-val-- GN S sy%v T' 0� 0+*J %Ae M,� V-OCWV \ No MYt SHOP ate: Discussed with: Si ned: t --��-j (Print) L.s�t,00 Ins ecting ricer: 0 attalion 1 2 3 4 5 6 7 Station: l FPB AtJA By order of the Fire Chief: You are hereby notified to correct all violations immediately or shcfw cause why you should not be required to do so. A re -inspection will be conducted on R - L3 Willful failure to comply with this notice is a r%isdemeanor. Violations that are not corrected immediately and/or remain after the re -inspection may be processed as a criminal offense. Thank you for your assistance and cooperation in minimizing the fire and life loss in our community. (H & S sec. 13112) White Copy — Station File Yellow Copy — Re-inspect/business Pink Copy — Business 0 Check when sent to prevention ire Prevention Bureau 76 Nelson Avenue Iroville, CA 95965 Ielephone 530-538-7888 ax 530-538-2105 Address: Manager: Owner. Butte County Fire Rescue California Department of Forestry and Fire Protection Facility Inspection Report Business Name: Bus: Bus: Bus: White Copy - Business Yellow Copy — Occupancy File Pink Copy — Station File Occ. Class. M Fax: AN 1NCPF.C'T1nN nF YniTR FAC H.1TV REVEALED THE FOLLOWING: 1. Fire Extinguishers: Required, service due 10. Exit(s) obstructed, inadequate '2. Extension cords: Excess use, defective 11. Exit sign(s) required, illumination 3. Excessive rubbish, trash, debris 12. Exit sign lights need replacing 4. Fire alarm system defective 13. Exit lighting: Required, defective 5. Sprinkler system: Service required, defective 14. Smoke detectors: Required, defective 6. Kitchen hood extinguishing system service due 15. Wiring: Exposed, damaged connectors, etc. 7. Fire walls, ceilings, fire doors, draft stops 16. Heating system: Defective appliance, flue combustibles 8. Knox Box keys 17. Address posted and visible from road 9. Fire Drill Witnessed Yes 11No [I18. Other DETAILED EXPLANATION AND CORRECTION S: UUKKLc:1 Eli: � LL CvR.2rC-riotJ ,MADt An 10-11-!l I Date: Discussed with: Signed: �0 (Print) Inspecting Officer: ,Battalion 1 2 3 4 5 6 7 Station: FPB FIRE PREVENTION SAVES LIVES, PROPERTY, AND BUSINESS. YOUR COOPERATION W1111 CORRECTING THE ABOVE LISTED ITEMS IS APPRECIATED. RE -INSPECTION DATE: I ID - ► 1 -11 Butte County Fire Department Business Name: California Department of Forestry and Fire Protection C�� Fire Prevention Bureau �'�� ''' 176 Nelson Avenue, Oroville, CA 95965 a 530-538-7888/530-538-2105(fax) Building Owner: Bus: ME Fire Safety Inspection Fire alarms stem defective Business Address: Business Name: 10. Owner/Manager: Bus: Other: Other Contact: Bus: Other: Building Owner: Bus: Other: ddress: Fire alarms stem defective Occ. Class: AN INSPECTION OF YOUR FACILITY REVEALED THE FOLLOWING: 1. Fire extinguishers: required, service due 10. Exits : obstructed, inadequate 2. Extension cords: Excessive use, defective 11. Exit sign(s): required, illumination, photo luminescent 3. Excessive rubbish, trash, debris 12. Exit sign lights: obstructed, defective 4. Fire alarms stem defective 13. Exit lighting: required, defective 5. Sprinkler system: service required, defective 14. Heating system: defective appliance, flue combustibles 6. Kitchen hood ext. system: service due 15. Wiring: exposed, damaged connectors, etc. 7. Fire walls, ceilings, fire doors, draft stops 16. Address posted and visible from road 8. Smoke detectors: required, defective 17. Other 9. Fire drill log checked Yes ❑ No ❑ 18. Other type of inspection — State below DETAILED EXPLANATION AND CORRECTIONS: CORRECTED: D-Yi• - Date: Discussed with: Signed: (Print) Inspecting Officer: Battalion 1 2 3 4 5 6 7 1 Station: FPB I By order of the Fire Chief: You are hereby notified to correct all violations immediately or show cause why you should not be required to do so. A re -inspection will be conducted on 1 r-, - -'tfI . Willful failure to comply with this notice is a q P `�� � P Y misdemeanor. Violations that are not corrected immediately and/or remain after the re -inspection may be processed as a criminal offense. Thank you for your assistance and cooperation in minimizing the fire and life loss in our community. (H & S sec. 13112) White Copy — Station File Yellow Copy — Re-inspect/business Pink Copy — Business 0 Check when sent to prevention Il ,& Cannip]Lal ss einl Golden Empire Council I Boy Scouts of America May 21, 2008 California Dept. Forestry and Fire Protection Butte Ranger Unit HQ 176 Nelson Avenue Oroville, CA 95966 Dear Sirs, This letter is to officially inform you that our Boy Scout Council will be conducting summer camp sessions at Camp Lassen in Butte Meadows from June 15 to August 10, 2008. During our camp sessions, we will have approximately 350 youth and adults. We are looking forward to a safe and exciting summer with our campers. If you have any questions about our camp and its program, please feel free to contact me. COUNCIL HEADQUARTERS 251 Commerce Circle Sacramento, CA 95815- 4292 Telephone (530) 929-1417 1-800-427-1417 FAX (530) 929-4461 CHICO FIELD OFFICE 561 E. Lindo Ave. #5 Chico, CA 95926-2217 Telephone (530) 342- 7460 FAX (530) 342-1442 Yours in Scouting, C. Jeff E. Chappell, Camp Director, 2008 Season YUBA CITY FIELD OFFICE Y 562 Clark Ave. Yuba City, CA 95331 Telephone (530) 822-9275 A United Way FAX (530) 822-9297 Agency REDDING FIELD OFFICE 3302 Bechelli Lane P.O. Box 992054 Redding, CA 96099 Telephone (530) 221-6230 FAX (530) 221-6412 I -A Catinnti> Lat feint Golden Empire Council I Boy Scouts of America March 26, 2006 California Dept. Forestry and Fire Protection Butte Ranger Unit HQ 176 ?Nelson A erne Oroville, CA 95966 Dear Sirs, This letter is to officially inform you that our Boy Scout Council will be conducting summer camp sessions at Camp Lassen in Butte Meadows from June 19 to August 9, 2006. During our camp sessions, we will have approximately 350 youth and adults. We are looking forward to a safe and exciting summer with our campers. If you have any questions about our camp and its program, please feel free to contact me. COUNCIL HEADQUARTERS 251 Commerce Circle Sacramento, CA 95815- 4292 Telephone (530) 929-1417 1-800-427-1417 FAX (530) 929-4461 CHICO FIELD OFFICE 561 E. Lindo Ave. #5 Chico, CA 95926-2217 Telephone (530) 342- 7460 FAX (530) 342-1442 Yours in Scouting, ell Jeff E. Chappell, Camp Director, 2006 Season YUBA CITY FIELD OFFICE Oen 562 Clark Ave. Yuba City, CA 95331 Telephone (530) 822-9275 A United Way FAX (530) 822-9297 Agency REDDING FIELD OFFICE 3302 Bechelli Lane P.O. Box 992054 Redding, CA 96099 Telephone (530) 221-6230 FAX (530) 221-6412 yq,,, .. - f w. R', z-.,- •rs -�J{ t�`.,� r r�-•--.•on. - .o r w � �,�+��y �w��t.,, .,� -•,� ...n -.w.,-. - w ..-. , -- .... r� •�.. 'r •iy"•t'"r. '�`,. _r Y• rpt .Y-:,�2 `�`i`l�y�i'{�')�^(��Fi7', ��•. rF ,. �`�'•�. �j�I�.�{Tr.. - .��L: ;�,`irt'ii.._�'i�', �'�e �!'�W"-�S".,'Y•!�:�%J t{tt"{$�: ».Z. C:,'�r�,'., .. .,A,• s. j�•. .-Yr,. r t' "• - 'R tl.� �O� �•. • ire Prevention Bureau Butte County Fire Rescue _ White Copy -Business 6 Nelson Avenue California Department of Forest Yellow Copy — Occupancy File P rY oville,"A 95965 and Fire Protection Pink Copy — 5tati � File lephone 530-538+7888 Fyacillfi.Ins �ecton-Re ort Occ. Class. � p530-53+8-2105 :, ; Address: I Business Name: P'e��,VaHagerBus: Hm: Fax1V =ger: Bus: Hm: Owner. Bus: Hm- r it v. r.�A. — �, _ �. .. a ., ._ Axa w. �� •. _a. �. .+S .-- . •. sN nvcpFr nw .nF v( TrR FA["TT. ,RFVFA.T,FTI THF FO'FJJOWM C! 1. Fire Extinguishers: keq*rqd,'servicedue 10. Exits) obstructed, inadequate 2. Extension cords: Excess use, defective 11. Exit sip(s) required, illumination 3. Excessive rubbish, trash, debris 12. Exit sign lights need replacing 4. Fire alarm system defective 13. Exit lighting: Required; defective 5. Sprinkler system: Service required, defective 14. Smoke detectors: Required, defective 6. Kitchen hood extinguishing system service due 15_ Wiring: Exposed, damaged connectors, etc. T. Fire walls, ceilings, fire doors, draft stops 16. Heating system: Defective appliance, flue combustibles 8. Knox Box keys 17. Address posted and visible from road 9. Fire Drill. Witnessed Yes[] No 18. Other WTA11 PLANATION AND CQRRECTILUNS:1 .� � : , �fi ,;rte' : , . �,! �� ~�- ` i .� f'`l�` ��.��i.,� �► :.+�F ¢ �.•� .� � � �V S .r ew 13 4 2z/ 7RA -7 r l z.-, OItRC. .G} .:$E :ABOVE I�ISTED ITEMS IS APPRECIATED. RE -INSPECTION DATE. .� ate: �` Discusse .'t Sign , !g.1 not battalion 3 4 5 6 7 Station: • FP Insp g Offic . V_ SAVES LIVES PROPERTY AND BU CESS. YOUR COOPERATION WITH OItRC. .G} .:$E :ABOVE I�ISTED ITEMS IS APPRECIATED. RE -INSPECTION DATE. .� ate: �` Discusse .'t Sign , !g.1 July 7, 2005 Camp Lassen BSA 559 East Lindo Avenue Chico, CA 95926 RE: Annual Organized Camp Inspection -Camp Lassen BSA On June 30, 2005, an inspection was conducted at the above -noted organized camp for compliance with applicable California Health and Safety Code statutes and 17 CCR regulations. At the time of inspection, the camp was occupied beyond capacity (reportedly 456 campers). Sleeoing Areas Pirelli Cabin 1. Repair/Replace light cover Roseburg Cabin 1. Repair smoke detector 2. Repair/Replace light cover Knudsen Cabin 1. Repair smoke detector 2. Repair/Replace light cover L.Q.S. Cabin 1. Repair/Replace light cover Rotary Cabin 1. Repair smoke detector Lodge Dining Hall — Restrooms Ladies' Restroom 1. Replace broken plexi -glass on shower stall door 2. Replace broken tiles in both shower stalls 3. Remove mold/algae from both shower stalls 4. Replace shower curtains (ripped) in both shower stalls 5. Clean floor tiles to remove brown stains in both shower stalls 6. Abate for gnats, spiders, flies and other insects in shower stalls 7. Repair/replace splashguard at left sink in the dual sink area 8. Provide hot water to faucets/showers in a timely manner 9. Replace broken tiles at entry way of restroom 10. No paper towels available in dispenser 11. Repair broken soap dispenser so it doesn't pull away from wall 12. Seal/caulk gaps behind sinks 13. Provide adequate ventilation Men's Restroom 1. Replace broken tiles in right shower stall 2. Replace light in right shower stall 3. Clean tiles to remove mold/algae from floor 4. Repair leak at faucet at two of the three hand sinks (single hand sink is flowing at approx. % GPM rate) 5. Slow drain at right hand sink --water pools and fills sink prior to draining 6. Provide adequate ventilation Wheelchair Ramp 1. Observed used wheelchair ramp installed behind Lodge Dining Hall. Right rail of ramp appears to be rusty and has jagged ends. New rail was on order at time of inspection and is projected to be installed by 07/09/05. Grounds: Observations & Improvements 1. Septic tank and leach field marked and to be installed with 333 feet of leach line to service the South Shower Building—work completion expected by end of Summer 2005 2. Septic tank and leach field marked and to be installed with 400 feet of leach line to service Two -Story Building, Cook's Cabin, laundry facility and the Health Cabin --work completion expected by end of Summer 2005. 2 3. Septic tank was last pumped May 2005 and yielded four (4) 2,800 -gallon tank full loads. Septic invoice was not readily available at time of inspection. Camp manager to fax invoice to this Department. 4. 1974 Doublewide mobile home placed at North end of property (near Adirondack sleeping quarters). Mobile home is not currently used and is proposed to be a sleeping quarters for 18 year old (plus) male employees. There are four bedrooms, one toilet, and one hand sink available. No shower installed. The projection is to have two toilets and two hand sinks by the end of the Summer 2005 season. The kitchen equipment has been removed and a wall is planned to isolate the kitchen area from use. There are three doors to the facility: the former dining area, the rear of the mobile, and off of the living room. There is a living room area adjacent to one of the bedrooms. Each bedroom is planned to have operational smoke detectors installed as well in the hallway. Lighted fire/emergency exits shall be places at all three exit doors. The mobile is reportedly plumbed into the current septic system with permits. This facility shall contact Butte County Building Department for further modifications regarding "Living Quarters" upgrades. Shower Building: Observations 1. Four shower stalls have been installed in one main building attached to The Trading Post. Four more shower stalls are scheduled to be "up and running" by the end of Summer 2005. Two of the shower stalls were not available for use due to vomit on floor in one and paper debris in the other. Shower stalls are painted and do not appear to be `waterproof" or nonabsorbent. Install FRP in areas exposed to water/steam. 2. A bank of four wall sinks have been installed on rough wood under a breezeway -like overhang on the west side of the shower building. Since rough wood is absorbent and not sanitary, sand & paint with washable paint or cover with FRP. The overhang was constructed so both ends of the building are open. Soap and paper towel dispensers have been installed above sink bank. South End Restroom - Ladies 1. No hot water available at hand sinks or showers 2. Abate for large number of spiders and insects in shower stalls South End Restroom — Men's 1. No hot water available at hand sinks or showers 2. Replace torn shower curtains 3. Remove wadded paper towels from hole in shower stall door and replace with sanitary door handle 4. Repair overflowing toilet containing fecal matter 3 ia- Medical Cabin Nurse's Exam Room & Hall C62 1. Hand sink install on rough wood surface. Install FRP or stainless steel behind sink to provide proper cleaning/sanitizing 2. Sharps box was full with a syringe plunger protruding out of box 3. No pump soap dispenser available at hand sink 4. Walls made of absorbent wood. Paint to seal 5. Fire extinguisher lying on floor in unmarked area. Clearly mark location 6. Exit signs do not illuminate in case of power loss 7. Faucet at hand sink in 2"d room on left, very loose Staffing 1. There is one Medic on staff at all times: Justin Nickell 2. There is one EMT on staff: Kent Anderson 3. There is one Registered Nurse on staff at all times: Cathy Newberger 4. There is one doctor available by telephone at all times: Dr. Joseph Matthews (Enloe Hospital, Chico) 5. All emergency staff's numbers are posted 6. Policy and Procedure manual on file 7. Patient log book on file (patient's name, date, time in, complaint, initials of caregiver, meds given) 8. Observed unlocked cabinet with sharp present, however Medic was in attendance and stated that sharps are kept locked when exam room not staffed. 9. observed medications in locked cabinet General Information: Campsites- Low dust, clean, drained Hazards — No obvious hazards noted Water supply -- No complaints regarding lack of water and/or water pressure. Monthly bacteriological testing required between April and September (when heavily populated) Drinking Fountains- Centrally located with 2 -inch squirt minimum Hand Washing Facilities -Centrally located. See above for deficiencies noted. Showers -Centrally located. See above for deficiencies noted. Toilet Facilities -Centrally located. See above for deficiencies noted. Plumbing- Plumbing appeared to be intact with exception to the above noted items Waste Disposal- No sewage surfacing noted on grounds; refuse contained Building Structures -overall structure of cabins noted above is good; see deficiencies listed above. 4 Sleeping Accommodations- Mattresses reportedly not being washed and sanitized between uses due to high number of campers and limited staffing available. Cleaning and sanitizing mattresses MUST occur between uses (new camper's use). Employee Housing -Appears to be within acceptable limits Fire Safety- Evacuation plan on file with camp director, orientation for camp leaders held upon arrival. Plan posted in main gathering locations. Current Fire Marshal --Life Safety Officer's inspection not available at time of inspection. Food Service- See separate food report (Kim Haas, REHS). Walk-in freezer, exterior to kitchen, was reportedly "down" for less than 24 hours and a repairman was on site at time of inspection. Food appeared to be in frozen state. Vector and Pest control -See deficiencies noted above Swimming- See separate bathing/swimming facility report (Kim Haas, REHS) Health Supervision -see above Camp Director -Camp director over 25 years old Counselors- Counselor list on file -adequate number/camper Notice of Intention to operate -Notification 30 days prior to operating Emergency Procedures Plan -Emergency Procedures Plan is on file with Camp Director and accessible to camp personnel. Thank you for assistance during the most recent inspection. Please do not to hesitate to call this Department with any questions or concerns regarding this report. Sincerely, Sherry Roney, REHS Butte County Public Health Department Division of Environmental Health Enclosures: Food Program Official Inspection Report Swimming Pool Official Inspection Report Small Water System Inspection Report 4 ire Prevention Bureau 76 Nelson Avenue )roville, CA 95965 telephone 530-538-7888 ax 530-538-2105 Address: I Manager: Owner: Butte County Fire Rescue California Department of Forestry and Fire Protection Facility Inspection Report Business Name: Bus: Bus: Bus: Hm: Hm: Hm: White Copy - Business Yellow Copy — Occupancy File Pink Copy — Station File Occ. Class. Fax: AN iNCPFCT10N nF VOITR FAC CITY REVEALED THE FOLLOWING: 111. Fire Extinguishers: Required, service due 10. Exit(s) obstructed, inadequate 2. Extension cords: Excess use, defective 11. Exit sign(s) required, illumination 3. Excessive rubbish, trash, debris 12. Exit sign lights need replacing 4. Fire alarm system defective 13. Exit lighting: Required, defective 5. Sprinkler system: Service required, defective 14. Smoke detectors: Required, defective 6. Kitchen hood extinguishing system service due 15. Wiring: Exposed, damaged connectors, etc. 7. Fire walls, ceilings, fire doors, draft stops 16. Heating system: Defective appliance, flue combustibles 8. Knox Box keys 17. Address posted and visible from road 9. Fire Drill Witnessed Yes ❑ No ❑ 18. Other (DETAILED EXPLANATION AND CORRECTIONS: COKKE(1 LIJ: Date: Discussed with: Signed: (Print) Inspecting Officer: Battalion 1 2 3 4 5 6 7 Station: FPB FIRE PREVENTION SAVES LIVES, PROPERTY, AND BUSINESS. YOUR COOPERATION WITH CORRECTING THE ABOVE LISTED ITEMS IS APPRECIATED. RE -INSPECTION DATE: Fi% l!� PRE-ENGINEERED SYSTEM INSPECTION REPORT El QUARTERLY ElANNUALLY SEMI-ANNUALLY ElNEW INSTALLATION INSPECTION NO. INVOICE NO. BUSINESS ADDRESS -2— l 3 C� �T Ur CITY STATE ZIPCODE �liT%� ����v� S M NAGER/OWNER - PHONE SY 3TEM LOCATION AREA TYPE SYSTEM AMT. MODEL NO. q/1 /o ' -ztiP< �25, XC I CY INDER SIZE METHOD OF ACTUATION AMT. DEGREE OF ACTUATION SYSTEM INSTALLED AS PER PLATE NO. PAGE T DATE OF HYDROSTATIC TEST LAST DATE OF RECHARGE CYLINDER SERIAL NO. FUEL SHUT OFF S� iv SIZE) ELECTRIC SIZE P RSHOW APPLIANCES AND LOCATION 0F, -3b4 -,(/CE NOZZLES ESTAURANT 1 j yARINE ❑ INDUSTRIAL . . . . . . . . . . . . . . . . . . . . . . . H ---------- —�i, ---- <!ga — -------- t ---------------- L . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d.......... CJD 3y„ JAS (I 1. IS SYSTEM MOUNTING BRACKET IN ACCESSIBLE LOCATION AND SOUNDLY MOUNTED? ......................................... 2. IS PIPING TIGHT, SECURED AND CHECKED FOR BLOCKAGE?..................................................................... 3. ARE GREASE TIGHTS INSTALLED AT ALL HOOD PENETRATIONS?................................................................. 4. IF MULTIPLE SYSTEMS, DID ALL SYSTEMS OPERATE SATISFACTORY? ............................................................. 5. IS SYSTEM PROPERLY INSTALLED FOR AREA(S) TO BE PROTECTED?.............................................................. 6. ARE ALL NOZZLES PROPER TYPE AND SIZE?...................................................................................... 7. IS MANUAL PULL OPERATIONAL AND IN PROPER LOCATION?..................................................................... 8. ARE FUSIBLE LINKS, H.A.D.S OF PROPER TEMPERATURE RATING?................................................................ 9. WERE FUSIBLE LINKS REPLACED ON SEMI-ANNUAL INSPECTION?................................................................ 10. IS AUTOMATIC DETECTION OPERATIONAL? ................ c .. y. ........................... 11. DID FUEL SHUT OFF PROPERLY? , i1iO.� .5.. [............................ G l !iG ......... 12. DID ELECTRIC SHUTOFFS/ALARMS OPERATE?.................................................................................... 13. ARE BURSTING DISC AND CHEMICAL IN GOOD CONDITION?...................................................................... 14. IS CARTRIDGE WITHIN THE REQUIRED WEIGHT?.................................................................................. 15. ARE NOZZLES CLEAN AND CAPS/SEALS PROPERLY INSTALLED?.................................................................. 16. IS CYLINDER PRESSURE IN OPERATIONAL RANGE?............................................................................... 17. ARE FILTERS CLEAN?................................................................................................. 18. ARE ALL SAFETY PINS REMOVED, CARTRIDGES RE -INSTALLED AND SYSTEM REPLACED IN NORMAL OPERATION CONDITION? .. 19. HAVE PERSONS WORKING IN SYSTEM AREA BEEN INSTRUCTED AS HOW TO OPERATE SYSTEMS BY MANUAL METHODS? ........ 20. WERE THE INSPECTION AND MAINTENANCE PERFORMED IN ACCORDANCE WITH THE PRESENTLY ADOPTED EDITIONS OF NFPA 17,17A AND 96?........................................................................ 21. WAS THE SYSTEM TAGGED IN ACCORDANCE WITH RULE 4A-21.240? ("NO" ANSWER MUST BE EXPLAINED IN THE COMMENTS SECTION OF THIS REPORT.).......................................................................................... 22. WERE THE INSPECTION AND MAINTENANCE PERFORMED IN ACCORDANCE WITH THE MANUFACTURER'S MANUAL AND THE MANUFACTURER'S SPECIFICATIONS?........................................................................................ 23. DOES SYSTEM COMPLY WITH UL300?................................................................................ . I, �HE UND�FRSIGNP, CEYIFY THAT I PERSONALLY INSPECTED THE ABOVE PREMISES AND FOUND CONDITIONS AS NOTED. RVIC I / DAT) %j AM TIME CUS SIGNATURE DATE C / F j 1 04 11119 7 nrr_ir+r nnnv PRE—ENGINEERED SYS (EM INSPECTION REPORT El �UARTERLY ❑ ANNUALLY ' ❑1 SEMI-ANNUALLY El INSTALLATION INSPECTION N0. CE NO. 7/01 BU 1 ESS �&� S cif= AD R SS CITY STATE ZIP CODE MA A ER/OWNER PHONE SYSTE M LOCATION AREA TYPE SYSTEM AMT. MODEL NO. [�//,, Wt�% / 1 i 1W�%/ 4i Y / i r /c l-L.�.�,� r'7�c� <c> 1 /I cel CY IN ER SIZE METHOD OF ACTUATION AMT DEGREE OF ACTUATION SYSTEM INSTALLED AS PER PLATE NO. PAGE L6. -I iI /" - ",0 0 LA T DATE OF HYDROST ICiTEST ��%� LAST DATE OF RECHARGE CYLINDER SERIAL NO. FUEL SHI,J.i OFF , / GAS SIZE . ELECTRIC SIZE SHOW APPLIANCES AND LOCATION OF SURFACE NOZZLES RESTAURANT ❑ MARINE ❑ INDUSTRIAL c 1. IS SYSTEM MOUNTING BRACKET IN ACCESSIBLE LOCAT!ON AND SOUNDLY MOUNTED? ........................................ 2. IS PIPING TIGHT, SECURED AND CHECKED FOR BLOCKAGE?................................................................ . ..... 3. ARE GREASE TIGHTS INSTALLED AT ALL HOOD PENETRATIONS?.................................................................. 4. IF MULTIPLE SYSTEMS, DID ALL SYSTEMS OPERATE SATISFACTORY?.............................................................. 5. IS SYSTEM PROPERLY INSTALLED FOR AREA(S) TO BE PROTECTED?.......................................................... . ... 6. ARE ALL NOZZLES PROPER TYPE AND SIZE?....................................................................................... 7. IS MANUAL PULL OPERATIONAL AND IN PROPER LOCATION?...................................................... ................ 8. ARE FUSIBLE LINKS, H.A.D.S OF PROPER TEMPERATURE RATING?................................................................. 9. WERE FUSIBLE LINKS REPLACED ON SEMI-ANNUAL INSPECTION?................................................................. 0. IS AUTOMATIC DETECTION OPERATIONAL?........................................................................................ 1. DID FUEL SHUT OFF PROPERLY?.......................................................................... ......................... 2. DID ELEQKRIC SHUTOFFS/ALARMS OPERATE?..................................................................................... 3. ARE BURSTING DISC AND CHEMICAL IN GOOD CONDITION?....................................................................... 4. IS CARTRIDGE WITHIN THE REQUIRED WEIGHT? .......................... ,........................................................ 5. ARE NOZZLES CLEAN AND CAPS/SEALS PROPERLY INSTALLED?.................................................................... 6. IS CYLINDER PRESSURE IN OPERATIONAL RANGE?................................................................................ 7. ARE FILTERS CLEAN?............................................................................................................... 8. ARE ALL SAFETY PINS REMOVED, CARTRIDGES RE -INSTALLED AND SYSTEM REPLACED IN NORMAL OPERATION CONDITION? ... 9. HAVE PERSONS WORKING IN SYSTEM AREA BEEN INSTRUCTED AS HOW TO OPERATE SYSTEMS BY MANUAL METHODS? ......... 0. WERE THE INSPECTION AND MAINTENANCE PERFORMED IN ACCORDANCE WITH THE PRESENTLY ADOPTED EDITIONS OF NFPA 17.17A AND 96?......................................................................... 1. WAS THE SYSTEM TAGGED IN ACCORDANCE WITH RULE 4A-21.240? ("NO" ANSWER MUST BE EXPLAINED IN THE COMMENTS SECTION OF THIS REPORT.)........................................................................................... 2. WERE THE INSPECTION AND MAINTENANCE PERFORMED IN ACCORDANCE WITH THE MANUFACTURER'S MANUAL AND THE MANUFACTURER'S SPECIFICATIONS?........................................................: 3. DOES SYSTEM COMPLY WITH UL300?................................................................................. . 76 /Jft I, TOE (UNDERSIGNED, CERTIFY THAT I PERSONALLY INSPECTED THE ABOVE PREMISES AND FOUND CONDITIONS AS NOTED. ISEEVI�ETECHNIC)AN' i,.-� DATE �! TIME CUSTOMER SIGNATURE DATE FL 1[041 1/97 No•.� �.-tJ `t Office of the State Fire Marshal C*FICE "CE �` CAMP INSPECTION REPORT STATE FIRE MA HAL e-�" • (_ti r- ��L 1� l _ .� ��L, me of Camp: ,-Z C , L . �.. t--. ......... ...... --7 dress: ;iness/Head• ` `�=�� --�1 r� quarters Address: ector's Name: Interviewed: 6 C ;.g 4k" E vf IDA P TES�-,Of,,, OPERATION uftime N crit r� rty�: FV A tr% 0.e� ts 4 17 Y 0 0 CHECKLIST NA = Not Applicable OK = in Compliance SR = See Remarks(use other side) Tents Under 80 sq. ft. No.C • Ic Tents/Tent Structures No. (max 800 sq. ft. 1 story 12 cap) Special Buildings No. 800 ft. (max 5% 1 story 12 cap) Buildings over 800 sq. ft.: Name/Use In accordance with the Building • Survey Report dated U U a. - b. -T-1 \:,L ---F C. -�7 -:3 Jf,- r-70 494 d. - 5, e. T 6;' W liz! Y"'A R V■ 4 N.' Oofti!616.� kii�yr IFire" Ex- t i n` e bal ue .tyt pis 'N M 4t-. e. 'M jqu1d.Sr:V FlAinm'a'• ble' L bneial Oedc P11 ir -tiouse ee re >,. .r �, .r' Hh'' D L 'epi-. a•>r 64 .s+ El ok ctild 6� SaWy c6eel& 16d ih A copy., W 6 16d) �`A -a ? 14, _0 June 16, 1997 Jim Daley Fire Chief California Correctional Facility, Susanville P. O. Box 970 Susanville, CA 96130 Dear Chief Daley. On behalf of the Golden Empire Council, Boy Scouts of America, I would greatly appreciate any consideration of the donation of 2 used kitchen Ansil Fire Prevention systems to our summer camping facility, Camp Lassen. It has been brought to my attention from Jack Pinsky that 2 systems may be available. We will be in a position to pick up the units from your facility. The need to upgrade our fire prevention system is one of our highest priorities as the camp is being used by many youth groups and schools. This year alone we expect over 7,000 youth, councilors, adults and parents from 40 plus groups, of which over 2,800 are Scout related. Camp Lassen is used by several school districts for their Outdoor Education Program, Kids at Risk from many alternative High Schools and a host of other church youth groups and community youth groups including Girl Scouts. The need to keep our kitchen facility current with all fire safety standards is extremely high. The system currently being used, is an old many time modified ansil powder system. If the system is not out of date, I am sure it should be. Our Council is a approved agency for government surplus equipment. Go Established in 1934, Camp Lassen has been the site of an unforgettable outdoor experience for countless thousands and thousands of Boy Scouts in the local area. As of today, the service area of the combined Golden Empire Council takes in 19 northern California Counties from Lake Tahoe to Mt. Shasta, over to Hat Creek and down to Fairfield. With the addition of all the other groups, your help to keep our safety standards the highest possible Will be a huge plus to the safe operations of the food service program and the protection of the main lodge. If there is any other information you need, please do not hesitate to call me at 916-891-0287 hm or 518-4961 cell phone. Thank you for your time and consideration. I hope we will hear from you soon. Sincerely yours, James 4. Thorup Camp Volunteer cc Jack Pinsky Scott Johnson Dan Whitney Office of the State Fire Marshal CAMP INSPECTION REPORT No.: S of Camp: is: 2� 35 SLd��T 2i� Q2 ; — 4Z1c� IA L >s/Headquarters Address: Name: Interviewed: -T�)o- ` (-\ LTz 6 V Tt� �+ p � T1 1�� oillL7V � OPERA N 15i, C `�' r xK• �+ a- �� �,.'� x �� a w a v' .+ ribs z, �ummer�IVinte � '"� '' � r�"" �, , �'+ � ���"�w.. { u� F�r�ty�. .`.« e I )� .,y�-:4 .F,'pt'S�' •. �,. � fi,h� �l t �^.>'�� /�a`�[f k' s. �x i r i t �-�i?{� - �.! .• a i`n to Z'r�1�i�'3u!'�yfF'ITPi•�'•��'..`tt'4C M CHECKLIST NA = Not Applicable OK = In Compliance a •� a ° s a �` SR = See Remarks (use other side) Tents Under 80 sq. ft. No.too L 114"A , 141A lL C Tents/Tent Structures No. (max 800 sq. ft. 1 story 12 cap) Special Buildings No. (max 800 sq. ft. 1 story 12 cap) CV— Ncl SIL C [ Buildings over 800 sq. ft.: Name/Use In accordance with the Building Survey Report dated b. CAP), C., -I`TY (,C- d. L",C,1L— e. P.JLLTi.LI T?Q-`tom y r � •~� � �.i.,b1i ' �� �, y7{ F � �t > l ,F, R", t ortable fire. uisl ell cite ety ked i r . laminable U gtitds .©tder us�k+3e 'fig; Dnp s >=treafet -dire l uug I� )d `(cop attach �t " _ :trl r -rst� ���*����„ .: c... ...<� -j ,t ., , � fx � t�� iC '•i�' Lta`i'.}!.l[ Et � 'b�:'Xi ! .£t�, a " 15i, ribs z, wi 6 (Rev. 7/86) Office of the State Fire Marsl. Fire Safety Correction Notice File No: �- l Name: Address: ^� �j L� �-►� E SF - a. I t CALIFORNIA STATE FIRE MARSHAL —�--s v ` f zj c A The California . Health and Safety deficiencies be corrected. Code and the State Fire Marshal's regulations require the following fire safety l ,5 1 L t S -- Q-) / 02- S C. The above deficiencies are to be corrected within days. When ALL deficiencies have been corrected, sign and return the certification on the opposite side of this form. If you have any questions, contact the Office of the State Fire Marshal aq( ) ISSUED BY (Deputy State Fire Marshall RECEIVED BY DATE EN -11 (Rev. 7/861 89 y1 51 DISTRIBUTION: GREEN—Facility WHITE—Region YELLOW—Field Office of.the State Fire Marshal a�F�E�. CAMP INSPECTION REPORT STATE FIRE MA HAL SHe No.. 57 Jame of Camp: ,/,\ LA kd ress: iness/Headquarters Address: ?ctor's Name: -Z --7 Interviewed: tAA 1 &-rl -!� u 4<, '1 :; -- qct, iQ 1 ♦. .��i ,',u. �it'i ?�`.i��. r , • ' G ",.:. . 1�'" ;Y[:,�t'Ft�° •+�)-f,+�l�... ..•: "� "..Y '}F.:-- 'sr. y;..• y> _ �,(• _ ayd'..s'i wsx"T ,•"^ ,.L ScL:'.ti* •;r;,` t ?rw/ 'p.itj;. 4?i s"Qv.. .• X%a'.i 2"V), �.�c'.✓3': R :»: ..r•- -. •~ iM1i Ci.:j• r". {t 11'..y•t`a.. ., a�. :,.'•A� y '� '-�;. 9 f:v. :.'r}'Y r'...i (.f3#" I �.wc.. )y: '�`i.:, -. t' ,Y••. >%, ti ,�•-., w:'f .-�<y >��F1yNa, •.. + .'4w •,:_. `'! •.7. ::i:. • ,.y_. .,. .,;'7. it.�.... t.• ! s�,�,. !.•.' .?f ',.i. ..,r.. ,��: .Y(4 t•t,' ..%t:l'. • ..f s •: t:'>:� ; Kr .3+'yFr ..r:. _ > .)•. y ::, l'• {7. '!�:.. R '>4•C', w. 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A. .>�� •:+'.f-. :r l _ 4. .. _f?jltcs ,_Y4, if_• ..•HI-.<t:it '�t}c.?~r •.. i •r z<r. .` 44... .c. :�:-:: . Y. II�tAI�-, :i �.. •n .�:•V J•2- wt:. �t•i. .:� 9',)A t• .°+.►,^w^: ,is y� >�:>w' '•t r] `i `i` .`+ `. f/1'.�•> ,..mss <o ii.�3. '.r„r,'y'! :l• :j. Y. x>5...2X�. `. ,{, :Ifrt•_/r�_wr•I �I��,l�ttr`!♦t o .{. •'A s ✓.' -. < S C' \ ..♦ • >D'; <•' >Y, �•"�•,}� R: ' t� " k �P' .r{ .� - L:S I_ .v -s ,;n,.,"1f.5 . st,�,:. 'c •!-> 5„ .• y�V.' l [j �y:' .•1 R. �• 3' • "a' t'�ix a' V . \'. .•,. it. •:`4X r .tj}."ir�1�_.i. E,� 4�t Y a:+�' �,;} •s 'C�, :.A�r^� ::v%1' °3 r "�C •�,'.<,^• - CHECKLIST NA = Not Applicable OK = In Compliance° �► € `�' �' ,; SR = See Remarks use other side G ents Under 80 sq. ft. 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'a.a . vt y�� ♦..•. '� ,,y •a .► 2 , r,♦... i,»T t 4 a.�. �� i V Y w >^i .r9. �a' sty, ar 3• .4) _y,..;.•� t . �>• ���nr, .. �, .:p�e�> :i R, is•• - M.> �t l.i':7. �l`i L* 'tw `-.t • .. .t�:a b' .•�•'i-' +�i .•'i; '.: 1� �. .� i, aha.. ., _•4. _ �T , • t :R •;!'.� •'r �• , 3's '!- '4A "�. f iii'' �1 f �..•t�` � rY ` � �1€ \'si• v'�'!''�r!:,A yl�e� {,,..'x,',}3.. ,•-�'' i •[,� �' �aY'..ti � y. Ai ,�;1- 2 • ,.,' 'R..,r>- - 1-: \ ` + ♦ »': "•C ,: ��if� .l: a�NinT.lb - � Y �+ �^ .f .. .. • r `,.. 1. s: > i , �, i • . at ;t' .'..�.� '•i'. L : t. <. � a . i w~ - • � EN 6(Rev. 7/86 Office of .the State Fire Marshal CAMP INSPECTION REPORT of Camp: is: ess/Headquarters Address: :tor's Name: Summer „to to _ NA = Not Applicable OK = In Compliance STATt1S 1 F rt DFPIlTYeST 'Tt kft.,&x `a ta DATE ) iv e 3 �a 4 SR = See Remarks (use other side) r` A C f Tents Under 80 sq. ft. No. COL 0 lL 0 J/� N k, /v A C (L- O cL Tents Tent Structures No. (max 800 sq. ft. 1 story 12 cap) Special Buildings No. (max Boo sq. ft. 1 story 12 cap) `4— A _ -t(-- cv A ccv— r'(/ Il� 1I /' Fl i.L / V— Buildings over 800 sq. ft.: Name/Use In accordance with the Building Survey Report dated a. I 1/to-9 ry b. C t N C. n d. e. �rtable Fire Extinguishers Date Serviced Camp Alarm :Flammable Liquids' h General Order Housekeeping ►re Drills ❑ FretSafety Corrections letter ' EN ,j1 issued in -field (copy attached) s¢ .0,4 FRE CLEARANCE.3' �' f 7� � .. ,. ATE ? iso` * a " _ r r .'?P J I s _ f tt STATt1S 1 F rt DFPIlTYeST 'Tt kft.,&x `a ta DATE ) iv e Office of the State Fire MarshG. Here Safety Correction Notice t He No:..,.,i lame: dress: 0 &FICE0 'I STATE FIRE MA HAL The C I 6'r;hta', .-Health an"d' 'Safe VCode and _the F• rshaulations requir e oowng.,.re',fe ty t tciencies.'ue.�corr -e d 6"t ec d 11 (Rev. 7/86) 86 96708 DISTRIBUTION: GREEN—Facility WHITE—Region YELLOW—Field Office of the State Fire Marshal CAMP INSPECTION REPORT No.:�S' of Camp: ss/Headquarters Address: ��� �� cr� s Name: Interviewed: FRE C1fARMICE GRANTED DATES OF OPERATION: STATUS Summer: ,_ __ to _ Winter: \ to to to to to CHECKLIST NA = Not Applicable OK = In Com liance�t I ° y� ,7 SR = See Remarks (use other side) r9 c7� 1� F 3 Tents Under 80 sq. ft. No. L2& Cv- i,(6- ou, 14 IJ 04 V(_— (� Tents/Tent Structures No. (max 800 sq. ft. 1 story 12 cap) Special Buildings No. -44 (max 800 sq. ft. 1 story 12 cap) co ( etz, O (Z- D .J LBuildings M Buildings over 800 sq. ft.: Name/Use -ELL- In accordance with the Building Survey Report dated a. tj 1 10 b ,?,j7'7 5 t _ , L ,� d `liv/ e. i L� T� ? L 4� ❑ Portable Fire Extinguishers: Date Serviced �7 L a -Camp Alarm ,❑ Flammable Liquids p`General Order -Housekeeping J2- ire Drills ❑ Fire Safety Corrections: — Letter : €N-11 issued in field (copy attached) FRE C1fARMICE GRANTED T UATF STATUS DEPUTY STATE FRE iAL{ � _.".. DATE \ l I EN -6 (Rev. 7/86) No.: — ne of Office of the State Fire Marshal CAMP INSPECTION REPORT 'Headquarters Address: C'ti� -Aa-a CA`\ -\ L0 C_,% ` Ott Z� s Name: Interviewed: �� �,�L�-`\-n�_� DATES OF OPERATION: Summer:�� to `�- Winter: to STATUS to �Ll l to DATE to to CHECKLIST NA = Not Applicable = In Compliance e ° > SR SR =See Remarks (use other side) Tents Under 80 sq. ft. No. Tents/Tent Structures No. (max 800 sq. ft. 1 story 12 cap) Special Buildings No. (max 800 sq. ft. 1 story 12 cap) Buildings over 800 sq. ft.: Name/Use In accordance with the Building Survey Report dated a. � t►J 1 f� � �� 1, d. °Lt?aY_5 e. LA-) S �jZ C Portable Fire Extinguishers: Date Serviced — Camp Alarm Flammable Liquids General Order -Housekeeping E'fire Drills ❑ Fire Safety Corrections: — Letter EN -11 issued in field (copy attached) i I ARE CLEARANCE GRANTED T -DATE STATUS DEPUTY STATE FIRE M RSFIAL JA E::2 DATE 1 J \ EN'. -6 (Rev. 7/86) 7 ............ , utte county = LAND OF NATURAL WEALTH AND BEAUTY z DEPARTMENT OF PUBLIC HEALTH I DIVISION OF ENVIRONMENTAL HEALTH Address ❑ 196 Memorial Way ❑ 7 County Center Drive 747 Elliott Road Reply to Chico, California 95926 Oroville, California 95965 Paradise, California 95969 Telephone: 916/891-2727 Telephone: 916/538-7281 Telephone: 916/872-6308 May 22, 1991 State Fire Marshall 4 Williamsburg Lane, Suite 3 Chico, CA 95926 RE: Summer Camp - Boy Scouts of America - Camp Lassen - Butte Meadows Dear Sir: This letter is to notify you that the Boy Scouts of America, Lassen Council is planning to operate a summer camp program at Camp Lassen, Butte Meadows, CA from July 7, 1991 through August 10, 1991. This notification is provided pursuant to Title 17, Section 30703- Notice of Intention to Operate. If you have any questions, please contact me at the above listed address or telephone number. Sincerely, �o�ward A Fnydter, REHS Division of Environmental Health HJS/sg cc: Boy Scouts of America Lassen Council (Attn: J. Thorup) P.O. Box 797 Chico, CA 95927 • ' • 5 j+ • ' A OF CALIFORNIA— -STATE AND CONSUME � , VICES AGENCY GEORGE DEUKMEJIAN. Gvv+ernoi ' .: iA T FIRS MARSHAL r 1 THERN REGION FLORIN ROAD, SUITE 4D0 - (916) 427-4325 . ATSS 466.4325 4 CA 9.'1823 TQ0 (414 4V-410. � k ' ...` I•. + r Ir •1 {"r jI':t, • � .. a . ,, { ' ORGANIZED CAMP FIRE CLEARANCE i , Camp Name : , '. Cam Location: P ct . . , iii M File Number. < L An inspection of this facility indicates substantial- compliance with the applicable provisions of Titles 19 and 24, California Administrative Code, , :Fire clearance is granted for a period not to exceed one ear from'the date of y .%, thq inspection, ; k ,•S , oil ; Date of Ins ect i qn : r P 1 { Special -Conditions: ' Issued by:. Date • C1 . 1.4 REF: SACR01@01 EN4 1 J 11 j . r • • • 1 1 i• 'I 1 •1 . f Office of the State Fire Marshal CAMP INSPECTION REPORT No.:?–"! 6/ cc, L, �`-> 0 - v '� `, - (� ne of Camp: C 1 L k IDS cress: `%i h t� k' �f i �'l �(A LA mess/Headquarters AddressGV�V �ti� �`SEC2 1 ?ctor's Name:_kipA0-f- \A- 99Interviewed: FIRE C=D T-0ATE STATUS DATES OF OPERATION: DEPL&Y STATE F E M L DATE C Summer: J�bN�: t`no Winter: to to to to to CHECKLIST NA = Not Applicable OK = In Compliance �° \ Ar SR = See Remarks (use other side)�?� Tents Under 80 sq. ft. No.A00 (S>_ Q411 CAL— &L, p t-� Tents/Tent Structures No. (max 800 sq. ft. 1 story 12 cap) Special Buildings No. _ (max fi00 sq. ft. 1 story 12 cap) �r� & V— IL + NIA n (9 ' t Y—Nk L & 7C�-AL Buildings over 800 sq. ft.: Name/Use In accordance with the Building Survey Report dated b. C. d. LA— mul-e. lb�n lJl� tnl 1�(` I Portable Fire Extinguishers: Date Serviced t � Cam Alarm P Flammable Liquids Eg� General Order -Housekeeping Fire Drills ❑ Fire Safety Corrections: - Letter EN -11 issued in field (copy attached) FIRE C=D T-0ATE STATUS DEPL&Y STATE F E M L DATE C 1.1 V EN -6 (Rev. 7/86) J O�FICc O gg�� 40c - OFFICE OF STATE FIRE MARSHAL SACRAMENTO REGION 4433 FLORIN ROAD, SUITE 400 SACRAMENTO, CA 95823 STATE)FIRE MARS -HAL ORGANIZED CAMP -- FIRE C L E A R A N C E EXPIRES FILE N0. 4J/J � LLJ W IB[ -I 14=J I-tc=1 LW 1=� WJ LU CAMP NAME0, ".0 LOCATION �%I ���t��'�>��-� ►2D An inspection on the date of issuance of this fire clearance indicates substantial fire safety exists as provided for in California Administrative Code,_ Title 19. In consideration of the special conditions noted bel•orv: FIRE CLEARANCE IS GRANTED FOR THE PERIOD OF TO 19 �. SPECIAL CONDITIONS: � L• V � -J l' � � 1!� White - Camp. Pink -- County Health Office Green - Office File EN -4 ( 1 1/81 ) BUTTE COUNTY DEPARTMENT OF PUBLIC HEALTH Division of Environmental Health 7 County Center Drive Oroville, CA 95965 (916) 538-7281 May 30, 1990 State Fire Marshall 4 Williamsburg Lane, Suite 3 Chico, CA 95926 RE: Summer Camp - Boy Scouts of American - Camp Lassen - Butte Meadows Dear Sir: This letter is to notify you that the Boy Scouts of America, Lassen Council is planning to operate a summer camp program at Camp Lassen, Butte Meadows, CA from July 1, 1990, through August 10, 1990. This notification is provided pursuant to Title 17, Section 30703 Notice of Intention to Operate. If you have any questions, please contact me at the above listed address or telephone number. Sincerely, Aow"ard er, Director Division of Environmental Health HJS/kf cc: Boy Scouts of America - Lassen Council - ATTN: Jim Thorup, P. O. Box 797, Chico, CA 95927 Office of the State Fire Marshal CAMP INSPECTION REPORT No.: 2 �— l 1 L �)-l2 (- Lt ; — C) C ---c ?--,- It of Camp: c ;s: ss/Headquarters Address: �U� 1� _LQ i �-�L1, cy Cl/4 C- �j Z x's Name: _ 111m 5 _� -CDLAI �� Interviewed: DATES OF OPERATION: Summer: _1l, l,1L- _1 4:5 to OCI_ �- �� - "Winter: to to to �. to` to CHECKLIST NA = Not Applicable OK = In Compliance ��° A z SR = See Remarks (use other side) c7a W 4 s` Tents Under 80 sq. ft. No. (k, .� ��( Ua �Jjl tJ A � N p((- l[� Tents/Tent Structures No (max 800 sq. ft. 1 story 12 cap) - Special BuildinNo.7� 7 (gs max 800 sq. ft. 1 story 12 cap) '✓ �,t/ Q,��. u(/ �r� �V C(�. �lf �"� V v Buildings over 800 sq. ft.: Name/Use In accordance with the Building Survey Report dated a. IN LQ w ( _\i� b. LL L -/AG t ti C.tj > L j ,,.lG d. t S Ss e. P -Portable Fire Extinguishers: Date Serviced � p I Camp Alarm Flammable Liquids Q__6eneral Order -Housekeeping OFire Drills K ire Safety Corrections: —Letter 6N-11 issued in field (copy attached) ;,'„ File No: Name: Office of the State Fire Marsh4 Fire Safety Correction Notice I IThe California Health and Safety Code and the State Fire Marshal's regulations require the following fire safety deficiencies be corrected:' tin. l t l _Z_ ` ( ('D The ab4e deficiencies are to be corrected within }`` days. When ALL deficiencies have been corrected, sign and reti6iO the certification on the opposite side of this form. If you have any questions, contact the Office of the State° Fire Marshal at ( } (ISSUED BY (Deputy State Fire Marshall RECEIVED BY DATE EN -I I (Rev. 7/86) 86 96708 DISTRIBUTION: GREEN—Facility WHITE—Region YELLOW—Field